Publications (15)29.61 Total impact
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Article: Maternal HIV Serostatus, Mother-Daughter Sexual Risk Communication and Adolescent HIV Risk Beliefs and Intentions.
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ABSTRACT: Daughters of HIV-positive women are often exposed to the same factors that placed their mothers at risk. This cross-sectional study (N = 176 dyads) examined HIV status, parent-teen sexual risk communication (PTSRC), and daughters' abstinence and condom use beliefs and intentions. Maternal HIV status was not associated with PTSRC. Path analyses show that maternal depression was associated with PTSRC behavioral and normative beliefs; relationship satisfaction was associated with PTSRC normative and control beliefs. Control beliefs were solely predictive of maternal PTSRC intention. PTSRC was associated with adolescent behavioral and normative beliefs. Abstinence beliefs were associated with abstinence intentions; condom beliefs were associated with condom use intentions. Relationship satisfaction was associated with adolescent control beliefs about both abstinence and condom use. There is a need for interventions that help HIV-positive mothers recognize their daughter's HIV risk and provide them with relationship building and parent process skills to help reduce these risks.AIDS and Behavior 06/2012; · 3.49 Impact Factor -
Article: Moving beyond safe sex to women-controlled safe sex: a concept analysis.
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ABSTRACT: This paper is a report of a conceptual analysis of women-controlled safe sex. Women bear disproportionate burdens from sexually related health compromising outcomes. Imbalanced societal gender and power positions contribute to high morbidities. The expression, women-controlled safe sex, aims to empower women to gain control of their sexual lives. Few researchers focus on contextualized socio-cultural definitions of sexual safety among women. The sample included scientific literature from Scopus, CINAHL, PubMed, PsychINFO and Sociological Abstracts. Papers were published 2000-2010. Critical analyses of literature about women-controlled safe sex were performed in May 2011 using Rodgers' evolutionary concept analysis methods. The search focused on social and cultural influences on sexual practices aimed at increasing women's control over their sexual safety. The analysis uncovered five attributes of women-controlled safe sex: technology; access to choices; women at-risk; 'condom migration' panic; and communication. Three antecedents included: male partner influence; body awareness; and self-efficacy. Consequences were categorized as positive or negative. Nine surrogate terms included: empowerment; gender power; female-controlled sexual barrier method; microbicides; diaphragm; sexual negotiation and communication; female condom; women-initiated disease transmission prevention; and spermicides. Finally, a consensus definition was identified: a socio-culturally influenced multi-level process for initiating sexual safety by women deemed at-risk for sexually related dangers, usually sexually transmitted infections and/or HIV/AIDS. This concept analysis described current significance, uses, and applications of women-controlled safe sex in the scientific literature. The authors clarified its limited nature and conclude that additional conceptual refinement in nursing is necessary to influence women's health.Journal of Advanced Nursing 11/2011; 68(8):1858-69. · 1.48 Impact Factor -
Article: Cognitive-behavioural health-promotion intervention increases fruit and vegetable consumption and physical activity among South African adolescents: a cluster-randomised controlled trial.
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ABSTRACT: Rates of chronic diseases are high among Black South Africans but few studies have tested cognitive-behavioural health-promotion interventions to reduce this problem. We tested the efficacy of such an intervention among adolescents in a cluster-randomised controlled trial. We randomly selected 9 of 17 matched pairs of schools and randomised one school in each pair to the cognitive-behavioural health-promotion intervention designed to encourage health-related behaviours and the other to a human immunodeficiency virus (HIV)/sexually transmitted disease (STD) risk-reduction intervention that served as the control. Interventions were based on social cognitive theory, the theory of planned behaviour and qualitative data from the target population. Data collectors, blind to participants' intervention, administered confidential assessments at baseline and 3, 6 and 12 months post-intervention. Primary outcomes were fruit and vegetable consumption and physical activity. Participants were 1057 grade 6 learners (mean age = 12.4 years), with 96.7% retained at 12-month follow-up. Generalised estimating equations revealed that averaged over the follow-ups, a greater percentage of health-promotion intervention participants than HIV/STD control participants met 5-a-Day fruit and vegetable and physical activity guidelines. The intervention also increased health-promotion knowledge, attitude and intention, but did not decrease substance use or substance-use attitude and intention. The findings suggest that theory based and contextually appropriate interventions may increase health behaviours among young adolescents in sub-Saharan Africa.Psychology & Health 02/2011; 26(2):167-85. · 1.69 Impact Factor -
Article: School-based randomized controlled trial of an HIV/STD risk-reduction intervention for South African adolescents.
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ABSTRACT: To test the efficacy of a school-based human immunodeficiency virus/sexually transmitted disease (HIV/STD) risk-reduction intervention for South African adolescents. A cluster-randomized, controlled design with assessments of self-reported sexual behavior collected before intervention and 3, 6, and 12 months after intervention. Primary schools in a large, black township and a neighboring rural settlement in Eastern Cape Province, South Africa. Nine of 17 matched pairs of schools were randomly selected. Sixth-grade students with parent or guardian consent were eligible. Two 6-session interventions based on behavior-change theories and qualitative research. The HIV/STD risk-reduction intervention targeted sexual risk behaviors; the attention-matched health promotion control intervention targeted health issues unrelated to sexual behavior. The primary outcome was self report of unprotected vaginal intercourse in the previous 3 months averaged over the 3 follow-ups. Secondary outcomes were other sexual behaviors. A total of 1057 (94.5%) of 1118 eligible students (mean age, 12.4 years) participated, with 96.7% retained at the 12-month follow-up. Generalized estimating equation analyses adjusted for clustering from 18 schools revealed that, averaged over the 3 follow-ups, a significantly smaller percentage of HIV/STD risk-reduction intervention participants reported having unprotected vaginal intercourse (odds ratio [OR], 0.51; 95% confidence interval [CI], 0.30-0.85), vaginal intercourse (OR, 0.62; 95% CI, 0.42-0.94), and multiple sexual partners (OR, 0.50; 95% CI, 0.28-0.89), when adjusted for baseline prevalences, compared with health-promotion control participants. This is the first large-scale, community-level, randomized intervention trial to show significant effects on the HIV/STD sexual risk behavior of South African adolescents in the earliest stages of entry into sexual activity.Archives of pediatrics & adolescent medicine 10/2010; 164(10):923-9. · 3.73 Impact Factor -
Article: Effectiveness of an HIV/STD risk-reduction intervention for adolescents when implemented by community-based organizations: a cluster-randomized controlled trial.
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ABSTRACT: We evaluated the effectiveness of an HIV/STD risk-reduction intervention when implemented by community-based organizations (CBOs). In a cluster-randomized controlled trial, 86 CBOs that served African American adolescents aged 13 to 18 years were randomized to implement either an HIV/STD risk-reduction intervention whose efficacy has been demonstrated or a health-promotion control intervention. CBOs agreed to implement 6 intervention groups, a random half of which completed 3-, 6-, and 12-month follow-up assessments. The primary outcome was consistent condom use in the 3 months prior to each follow-up assessment, averaged over the follow-up assessments. Participants were 1707 adolescents, 863 in HIV/STD-intervention CBOs and 844 in control-intervention CBOs. HIV/STD-intervention participants were more likely to report consistent condom use (odds ratio [OR] = 1.39; 95% confidence interval [CI] = 1.06, 1.84) than were control-intervention participants. HIV/STD-intervention participants also reported a greater proportion of condom-protected intercourse (beta = 0.06; 95% CI = 0.00, 0.12) than did the control group. This is the first large, randomized intervention trial to demonstrate that CBOs can successfully implement an HIV/STD risk-reduction intervention whose efficacy has been established.American Journal of Public Health 02/2010; 100(4):720-6. · 3.93 Impact Factor -
Article: Efficacy of a theory-based abstinence-only intervention over 24 months: a randomized controlled trial with young adolescents.
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ABSTRACT: To evaluate the efficacy of an abstinence-only intervention in preventing sexual involvement in young adolescents. Randomized controlled trial. Urban public schools. A total of 662 African American students in grades 6 and 7. An 8-hour abstinence-only intervention targeted reduced sexual intercourse; an 8-hour safer sex-only intervention targeted increased condom use; 8-hour and 12-hour comprehensive interventions targeted sexual intercourse and condom use; and an 8-hour health-promotion control intervention targeted health issues unrelated to sexual behavior. Participants also were randomized to receive or not receive an intervention maintenance program to extend intervention efficacy. The primary outcome was self-report of ever having sexual intercourse by the 24-month follow-up. Secondary outcomes were other sexual behaviors. The participants' mean age was 12.2 years; 53.5% were girls; and 84.4% were still enrolled at 24 months. Abstinence-only intervention reduced sexual initiation (risk ratio [RR], 0.67; 95% confidence interval [CI], 0.48-0.96). The model-estimated probability of ever having sexual intercourse by the 24-month follow-up was 33.5% in the abstinence-only intervention and 48.5% in the control group. Fewer abstinence-only intervention participants (20.6%) than control participants (29.0%) reported having coitus in the previous 3 months during the follow-up period (RR, 0.94; 95% CI, 0.90-0.99). Abstinence-only intervention did not affect condom use. The 8-hour (RR, 0.96; 95% CI, 0.92-1.00) and 12-hour comprehensive (RR, 0.95; 95% CI, 0.91-0.99) interventions reduced reports of having multiple partners compared with the control group. No other differences between interventions and controls were significant. Theory-based abstinence-only interventions may have an important role in preventing adolescent sexual involvement. clinicaltrials.gov Identifier: NCT00640653.Archives of pediatrics & adolescent medicine 02/2010; 164(2):152-9. · 3.73 Impact Factor -
Article: Fostering health equity: clinical and research training strategies from nursing education.
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ABSTRACT: Racism, ethnocentrism, segregation, stereotyping, and classism are tightly linked to health equity and social determinants of health. They lead to lack of power, money, resources, and education which may result in poor health care access and outcomes. Health profession faculties must address the complex relationships that exist between individual, interpersonal, institutional, social and political factors that influence health outcomes in both clinical and research training. Thus, the purposes of this paper are to provide examples of training strategies from nursing education that foster cultural sensitivity. First, assumptions about health equity, culture, ethnicity and race are explored. Second, clinical training within an undergraduate and graduate context are explored, including an undergraduate cancer case study and in a graduate pediatric nursing program are described to demonstrate how cultural models can be used to integrate the biomedical and psychosocial content in a course. Third, research training for summer scholars and doctoral and post doctoral fellows (short and long term) is described to demonstrate how to increase the number and quality of scholars prepared to conduct research with vulnerable populations. Research training strategies include a summer research institute, policy fellowship, and a scholars "pipeline" program. A unique perspective is presented through collaboration between a nursing school and a center for health disparities research.The Kaohsiung journal of medical sciences 10/2009; 25(9):479-85. · 0.61 Impact Factor -
Article: Sexually transmitted infection among adolescents receiving special education services.
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ABSTRACT: To estimate the relative risk of sexually transmitted infections (STIs) among children identified as having learning disabilities through the special education system. This cross-sectional study used special education data and Medicaid data from Philadelphia, Pennsylvania, for calendar year 2002. The sample comprised 51,234 Medicaid-eligible children, aged 12-17 years, 8015 of whom were receiving special education services. Claims associated with diagnoses of STIs were abstracted, and logistic regression was used to estimate the odds of STI among children in different special education categories. There were 3% of males and 5% of females who were treated for an STI through the Medicaid system in 2002. Among females, those in the mental retardation (MR) category were at greatest risk (6.9%) and those in the emotionally disturbed or "no special education" category at lowest risk (4.9% each). Among males, STIs were most prevalent among those classified as mentally gifted (6.7%) and lowest among those in the MR category (3.0%). In adjusted analyses, males with specific learning disabilities and females with MR or who were academically gifted were at excess risk for STIs. The finding that children with learning disabilities are at similar or greater risk for contracting STIs as other youth suggests the need to further understand their risk behaviors and the potential need to develop prevention programs specific to their learning needs.Journal of School Health 08/2008; 78(7):382-8. · 1.34 Impact Factor -
Article: Predicting condom use among sexually experienced Latino adolescents.
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ABSTRACT: There is limited research on how aspects of Latino culture affect condom use among Latino adolescents. In this study, the authors examined the effects of familialism, gender roles, and religiosity on condom use intentions and past condom use. Results showed only religiosity predicted past condom use; no other cultural variable had either a direct or an indirect effect on condom use intentions or past condom use. These findings represent an important effort in promoting safer sex behaviors among sexually active Latino adolescents.Western Journal of Nursing Research 11/2007; 29(6):724-38. · 1.19 Impact Factor -
Article: Recruitment and retention of Latino adolescents to a research study: lessons learned from a randomized clinical trial.
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ABSTRACT: To describe facilitators and barriers to participation and retention of Latino adolescents in a randomized clinical trial. Participants were part of a randomized clinical trial designed to reduce HIV sexual risk behavior among Latino youth. Responses from 106 randomly selected respondents from the 3-month follow-up were content analyzed. Four main facilitator patterns emerged: peer/family support, program incentives, commitment, and desire to help. Participation barriers included conflicts with other commitments, embarrassment, and lack of peer support. Recruitment and retention of Latino adolescents in research studies is critical to building a research base for nursing practice.Journal for Specialists in Pediatric Nursing 11/2006; 11(4):244-50. · 0.83 Impact Factor -
Article: A randomized controlled trial testing an HIV prevention intervention for Latino youth.
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ABSTRACT: To test the efficacy of a prevention intervention to reduce sexual risk behavior among Latino adolescents. Randomized controlled trial from April 2000 through March 2003, with data collection before and after intervention and at 3, 6, and 12 months. Northeast Philadelphia schools. Latinos aged 13 through 18 years (249 males and 304 females); 81.6% retained at 12-month follow-up. The HIV and health-promotion control interventions consisted of six 50-minute modules delivered by adult facilitators to small, mixed-gender groups in English or Spanish. Main Outcome Measure Self-reported sexual behavior. Analyses using generalized estimation equations over the follow-up period revealed that adolescents in the HIV intervention were less likely to report sexual intercourse (odds ratio, 0.66; 95% confidence interval [CI], 0.46-0.96), multiple partners (odds ratio, 0.53; 95% CI, 0.31-0.90), and days of unprotected intercourse (relative risk, 0.47; 95% CI, 0.26-0.84) and more likely to report using condoms consistently (odds ratio, 1.91; 95% CI, 1.24-2.93). Baseline sexual experience and language use moderated intervention efficacy. Adolescents assigned to the HIV intervention who were sexually inexperienced at baseline reported fewer days of unprotected sex (relative risk, 0.22; 95% CI, 0.08-0.63); Spanish speakers were more likely to have used a condom at last intercourse (odds ratio, 4.73; 95% CI, 1.72-12.97) and had a greater proportion of protected sex (mean difference, 0.35; P<.01) compared with similar adolescents in the health-promotion intervention. Results provide evidence for the efficacy of HIV intervention in decreasing sexual activity and increasing condom use among Latino adolescents.Archives of Pediatrics and Adolescent Medicine 09/2006; 160(8):772-7. · 4.14 Impact Factor -
Article: Physical Activity in Latino Adolescents: Understanding Influences on Activity Intentions
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ABSTRACT: Obesity has risen in all segments of the population but is more prevalent among Latino youth than non-Hispanic Whites. While physical activity is important in preventing obesity, little research is related to attitudes toward activity and intentions in Latino youth. This study describes activity attitudes and behaviors and examines predictors of activity intentions of Latino adolescents. Baseline data from 550 adolescents were examined as part of a larger HIV prevention intervention. Multiple regression analysis revealed attitude, acculturation, and past physical activity predicted future activity intentions. Separate analyses by gender showed attitude, acculturation, age, and past physical activity predicted intentions for boys. Only attitude and past physical activity predicted intentions for girls. Results represent initial efforts to understand the influences of behavior and intentions on physical activity in Latino youth. La obesidad ha aumentado en todos los segmentos de la población, pero es mas prevalente entre Latinos que en blancos no-Hispanos. A pesar de que la actividad física es un elemento importante en la prevención de la obesidad, pocas investigaciones han sido dirigidas a entender las actitudes y las intenciónes hacia la actividad física entre la juventud Latino. El estudio discutido describe tanto actitudes como comportamientos, y examina predictores de intenciónes hacia la actividad física entre adolescentes Latinos. Se examinaron datos de 550 adolescentes previo a que comenzara su participación en una intervención más amplia para la prevención del VIH. Analisis de regresión multiple revelaron que las actitudes, la aculturación y la actividad física pasada predicen las intenciones para la actividad fisica futura. Análisis adicionales por genero indican que las actitudes, aculturación, edad y actividad física pasada predicen las intenciones en los niños. Solamente las actitudes y la actividad física pasada predicen las intenciones entre las niñas. Los resultados representan un esfuerzo inicial para entender las influencias de los comportamientos y las intenciones hacia la actividad física entre adolescentes Latinos.Hispanic Health Care International 12/2004; 3(3):125-131. -
Article: Predictors of sexual intercourse and condom use intentions among Spanish-dominant Latino youth: a test of the planned behavior theory.
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ABSTRACT: Spanish-dominant Latino youth represent a growing yet underserved segment of the U.S. population, especially in terms of protection from sexually transmitted HIV infection. There is evidence to suggest that this subgroup engages in both risk and protective behaviors that may be different from the behaviors of English-dominant Latino youth. To examine theoretical predictors (attitude, subjective norm, behavioral beliefs, normative beliefs, control beliefs) of sexual intercourse and condom use with a sample of Spanish-dominant Latino youth. Participants in this study were part of a larger randomized controlled intervention designed to reduce the risk of sexually transmitted HIV among Latino youth. This article is based on preintervention data from 141 Spanish-speaking Latino adolescents (77 girls and 64 boys) who completed a Spanish version of the questionnaire. Multiple regression analyses showed significant effects of attitudes, perceived partner approval, self-pride, and parental pride on intentions to engage in sexual intercourse. Attitudes, intentions to engage in sex in the next 3 months, self-pride, parental pride, goals, and partner approval predicted sexual intercourse in the preceding 3 months. Attitudes, subjective norms, self-efficacy, partner and parental approval, and impulse control beliefs were significant predictors of intentions to use condoms. This study represents initial efforts to address the needs of Spanish-dominant Latino youth. The identification of salient beliefs that may predict sexual risk and protective behavior are relevant to the design of culturally and linguistically effective interventions.Nursing Research 53(3):172-81. · 1.40 Impact Factor -
Article: Designing a culturally based intervention to reduce HIV sexual risk for Latino adolescents.
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ABSTRACT: There is a pressing need to develop effective interventions to prevent sexually transmitted HIV infection among Latino adolescents. Although there have been few models to direct the design of culturally effective interventions, the processes of recognizing the influence of specific cultural and contextual variables, building on "what works," and integrating community perspectives are important elements. These processes were used in the development of a Latino culturally based curriculum designed to reduce the risk of sexually transmitted HIV among Latino youth. Specific examples are provided to illustrate how these processes were used and how the curriculum evolved.Journal of the Association of Nurses in AIDS Care 16(2):23-31. · 1.09 Impact Factor -
Article: Unwanted unprotected sex: condom coercion by male partners and self-silencing of condom negotiation among adolescent girls.
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ABSTRACT: This exploratory study used the theory of reasoned action and the theory of gender and power to guide elicitation of partner-related impediments to condom use among 64 adolescent girls living in poor urban areas with high rates of HIV and partner abuse. About 53% indicated that they had experienced unwanted, unprotected vaginal sex and 25% indicated that they were unable to discuss condom use with a partner. Novel qualitative findings related to condom coercion, condom sabotage, and self-silencing of condom negotiation are discussed in the context of connecting partner abuse to interpersonal control over condom use. Implications for intervention design are discussed.ANS. Advances in nursing science 34(3):243-59. · 0.97 Impact Factor
Top co-authors
Top Journals
Institutions
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2012
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University of Southern California
- School of Social Work
Los Angeles, CA, USA
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2009–2011
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University of Pennsylvania
- • Center for Health Equity Research
- • School of Nursing
Philadelphia, PA, USA
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2006
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University of Michigan
- School of Nursing
Ann Arbor, MI, USA
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2004
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Philadelphia University
Philadelphia, PA, USA
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